Dr. Dimitrios Kostopoulos & Konstantine Rizopoulos, along with their
organizations Hands-On Seminars &
Hands-On Physical Therapy support research
initiatives in the area of Manual Therapy & Rehabilitation. Both companies have
an annual allocated budget to support research initiated by employees and
associates of our organizations.
At the same time we support research initiatives by the American Physical
Therapy Association and the International Myopain Society.
Dr. Kostopoulos is Associate Editor of the Journal of Bodywork and Movement
Therapies and Hands-On Seminars endorses it. A brief sample of articles from
this journal is provided here .
Here are some of the articles published by our associates:
Improving posture: Comparing Segmental Stretch and Muscular Chains Therapy
José Luís Pimentel do Rosário, Inês Yoshie Nakashima, Konstantine Rizopoulos, Dimitrios Kostopoulos, Amélia Pasqual Marques
Clinical Chiropractic 10 January 2013 (Article in Press DOI: 10.1016/j.clch.2012.10.039)
Muscular Chains Therapy (MCT), which uses postural positions for global stretching, and Segmental Stretch Technique (SST), which stretches one muscle at a time, are two static stretching techniques currently used to improve, correct and treat postural imbalances. Aiming to identify which of these two techniques is most effective in order to improve standing posture, 30 women between 21 and 30 years old were evaluated and divided into three groups of 10 participants each: The SST group, the MCT Group and the Control Group (CG). Postures were evaluated before and after treatment through digital photographs. After transferring the images to the computer, tracings were made with Corel Draw software using six marked anatomical points: intertragic notch; anterior part of the lateral border of the acromion; suprasternal notch; posterior superior iliac spine (PSIS); anterior superior iliac spine (ASIS); the inferior angle of the scapula; and right lateral malleolus. The two experimental groups underwent eight sessions of stretching, twice a week, for about 30 min each session. The MCT Group was found more effective (p < 0.05) than the SST and CG in the variables ASIS (p = 0.001), PSIS (p = 0.001) and acromion (p = 0.001). No statistically significant differences were found in postural variables scapula, acromion-line and line-intertragic notch. In conclusion, the MCT stretching was superior to the SST in treating postural deviations.
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Points of Clarification: Delineating the distinction between acupuncture and dry needling for trigger-point pain
By Dimitrios Kostopoulos, PT, MD, PhD, DSc, ECS, and Konstantine Rizopoulos, PT, DPT, MCMT
Two instrument-assisted means of treating chronic pain conditions due to MyoFascial Trigger Points are acupuncture and trigger-point dry needling. Unfortunately, many therapists confuse the terms acupuncture and dry needling, or use the terms interchangeably. However, a clear and definitive distinction exists between the two modalities, and a distinction must be made to avoid confusion. Hands-On Seminars founders Dr. Kostopoulos and Dr. Rizopoulos expand the horizon of understanding of these techniques by explaining the differences in a thorough manner.
Delineating the distinction between acupuncture and dry needling for trigger-point pain
TRIGGER POINT DRY NEEDLING
Trigger Point Dry Needling is an effective approach for the treatment of MyoFascial Trigger Points. Dr. Kostopoulos and Dr. Rizopoulos have learned, researched, practiced and taught this very effective approach for many years. The Federation of State Boards of Physical Therapy - FSBPT as well as the American Physical Therapy Association - APTA published their position papers supporting the use of Dry Needling by Physical Therapists.
It is the view of Hands-On Seminars that Dry Needling is a therapeutic modality that fits within the scope of the physical therapy profession. We encourage PT programs to include dry needling as part of their undergraduate teaching curriculum. Hands-On Seminars and its founders offer courses in Dry Needling.
FSBPT Intramuscular Manual Therapy Dry Needling Resource Paper
APTA Dry Needling Resource Paper
Trigger Points: An Elusive Foe
Teaching myofascial trigger point therapy for over 18 years to more than 30,000 therapists worldwide, Dr. Kostopoulos and Dr. Rizopoulos have come to realize that
while therapists treat myofascial trigger points, many of them successfully, few of them have a deeper understanding of the pathophysiology
of a myofascial trigger point. With this article the worldknown experts provide a summary of various mechanisms responsible
for the genesis of myofascial trigger points.
Trigger Point Article Advance
Effect of topical aerosol skin refrigerant (Spray and Stretch technique) on
passive and active stretching.
Dimitrios Kostopoulos PT, PhD, DSc, MCMT and Konstantine Rizopoulos PT, FABS,
This study was sponsored by St. Matthew’s University School of Medicine.
Objectives: The purpose of this study was to examine the effects of the use of a vapocoolant blend of pentafluoropropane and tetrafluoroethane (Gebauer's Spray
and Stretch) on hip flexion stretching.
Methods: Thirty volunteers were randomly assigned to spray and stretch treatment
and stretch only control groups. Each group was assessed pre- and posttest on
passive and active hip flexion range of motion (ROM).
Results: Findings indicated greater posttest hip flexion gains for the spray and
stretch group over the stretch only group for both active and passive ROM.
Additionally, females achieved greater pre- and posttest differences on active
ROM compared to males.
Conclusions: Study findings suggest that spray and stretch techniques can be an
effective treatment in increasing hip flexion ROM.
Nerve conduction velocities in the lower extremity in patients with Raynaud's
phenomenon and clinical applications
Dimitrios Kostopoulos PT, PhD, DSc,
Konstantine Rizopoulos PT, FABS and Nikolaos Vartholomeos PT, DPT
Background and purpose: The purpose of the study is to study the nerve
conductivity of the tibial motor, peroneal motor, peroneal sensory, and sural
nerves in patients with primary and secondary Raynaud's phenomenon (RP).
Subjects: Twenty each: primary RP, secondary RP, and normal controls.
Methods: Electromyography using distal latency (DL) and nerve conduction
velocity (NCV) as dependent variables.
Results: Peroneal nerve DLs were slower and NCVs were weaker for the secondary
RP group compared to the primary RP group and controls. Tibial motor nerve DLs
from slowest to fastest were: primary RP, secondary RP, and controls. NCV
strength order was: secondary RP weakest, primary RP, and controls.
Discussion: Patients with secondary RP generally had the slowest DLs and the
weakest NCVs, with differences most pronounced in the motor nerves. With the
exception of the tibial motor nerve, patients with primary RP had similar NCVs
to the control group. Neural mobilization techniques can be applied to assist
with patient symptoms.
Treatment of carpal tunnel syndrome: a review of the non-surgical approaches
with emphasis in neural mobilization
Abstract: Carpal tunnel syndrome (CTS) results from the entrapment of the median
nerve at the wrist. It is the most common entrapment syndrome causing frequent
disability especially to working populations. Aside from the surgical release
approach there are other non-invasive therapeutic methods for the treatment of
CTS. This paper will review the evidence regarding neurodynamic testing and
neuromobilization of the median nerve as a treatment approach to CTS.
Reduction of Spontaneous Electrical Activity and Pain Perception of Trigger
Points in the Upper Trapezius Muscle Through Trigger Point Compression and
Dimitrios Kostopoulos, PT, PhD, DSc
Arthur J. Nelson, Jr., PT, PhD
Reuben S. Ingber, MD
Ralph W. Larkin, PhD
Objectives: Investigate the effects of ischemic compression [IC]
passive stretching [PS] in isolation and in combination on the reduction of
activity [SEA] and perceived pain in trigger points [TrPs] located in the upper
Methods: Ninety participants with TrPs in the upper trapezius muscle were
to three treatment groups: IC, PS, and IC + PS. TrP compression was applied on
the TrP for three
applications of 60 seconds each, followed by a 30-second rest period. PS was
applied for three
45-second applications, with 30-second rest intervals. All patients received the
same amount of
Results: Significant decreases were found in pain perception and on SEA
for all study participants.
The IC + PS group evidenced greater declines in pain perception and SEA when
to the IC and PS groups.
Conclusion: Because of ethical considerations, a control group design was
not possible, thereby
limiting the robustness of the findings. Although each technique significantly
reduced pain perception
and SEA, the combination of IC and PS was superior, apparently because of the
nature of the therapeutic interventions.
Journal of Bodywork & Movement Therapies is the Official Journal of Hands-On Seminars.
As a private practice owner I have realized that the Mastery Certification in Manual Therapy has contributed significantly in building a successful practice image to my community
V. Georgakopoulos, PT, MCMT